Neighborhood playability and early childhood development: a population-based birth cohort study

BACKGROUND: Outdoor play is important for children's health and development. Research indicates that neighborhood characteristics influence children's engagement in outdoor play, but no studies have examined associations between neighborhood playability and childhood development. METHODS: Using a population-based child cohort (n = 30,126) in Metro Vancouver, Canada, we studied the association between early-life neighborhood playability and early childhood development. Neighborhood playability, the suitability of an area for young children to engage in outdoor free play, and its five domains (traffic environment, spaces for play, social environment, natural environment, child-relevant destinations) was quantified with a novel geospatial metric. Early childhood development was assessed via teacher-ratings on the Early Development Instrument that measures children's development in physical, social, emotional, and cognitive domains (mean age = 5.6 years). Multilevel models were used to analyze the association between neighborhood playability, as measured by a composite score and individual domain scores, and early childhood development. RESULTS: Following adjustment for demographic and socio-economic variables, the highest quartile of composite neighborhood playability was associated with higher child development scores (b: 0.30, 95% CI: 0.05, 0.54) and lower odds of developmental vulnerability (OR: 0.90; 95% CI: 0.82, 0.98). Associations varied across playability domain scores, with the strongest positive association observed for the natural environment domain, followed by the social and traffic environment domains. Negative associations were observed for the child-relevant destinations domain score. CONCLUSIONS: The results suggest that increased neighborhood playability, particularly natural environments, may promote healthy early childhood development. Findings inform urban planning policies and interventions that support childhood development.